K Number
K031523
Device Name
OLYMPUS ULTRASONIC SURGICAL SYSTEM
Date Cleared
2003-10-01

(139 days)

Product Code
Regulation Number
N/A
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
OLYMPUS Ultrasonic Surgical System has been designed to be used with the Olympus SonoSurg generator Set (SonoSurg-G2 Set) and an electrosurgical unit to cut and coagulate soft tissue for laparoscopic and intraabdominal procedures in general (open) surgery. It is also designed to cut and coagulate soft tissue for open and endoscopic procedures in urologic surgery.
Device Description
The Olympus Ultrasonic Surgical System is composed of three sections, (1), (2), and (3). - (1) Olympus SonoSurg Scissors 5mm O.D. T3050" or "Olympus SonoSurg Long Hook 5mm O.D. T3060" or "Olympus SonoSurg Long Scissors 5mm O.D. T3070", or "Olympus SonoSurg Scissors 5mm O.D., HF Series. - (2) Olympus SonoSurg Transducer SonoSurg-T2H. - (3) Olympus SonoSurg Generator Set SonoSurg-G2 Set (SonoSurg-G2, MAJ-51). This device is intended to cut and coagulate soft tissue for open and endoscopic procedures in urologic surgery.
More Information

Not Found

No
The summary describes a traditional ultrasonic surgical system for cutting and coagulating tissue and does not mention any AI or ML components.

Yes
The device is described as being used to "cut and coagulate soft tissue," which indicates it is used for surgical procedures to treat and repair tissues, thus functioning as a therapeutic device.

No

The device is an ultrasonic surgical system designed to cut and coagulate soft tissue, not to diagnose conditions.

No

The device description explicitly lists hardware components (scissors, transducer, generator set) and describes a physical surgical system, not a software-only device.

Based on the provided information, this device is not an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use: The intended use clearly states that the device is designed to "cut and coagulate soft tissue" during surgical procedures. This is a direct surgical intervention on the patient's body.
  • Device Description: The components described (scissors, hook, transducer, generator) are all tools used for physical manipulation and energy delivery during surgery.
  • Lack of IVD Characteristics: There is no mention of the device being used to examine specimens derived from the human body (like blood, urine, tissue samples) to provide information for diagnosis, monitoring, or screening.

IVD devices are used in vitro (outside the body) to analyze samples and provide diagnostic information. This device is used in vivo (inside the body) for surgical treatment.

N/A

Intended Use / Indications for Use

OLYMPUS Ultrasonic Surgical System has been designed to be used with the Olympus SonoSurg generator Set (SonoSurg-G2 Set) and an electrosurgical unit to cut and coagulate soft tissue for laparoscopic and intraabdominal procedures in general (open) surgery. It is also designed to cut and coagulate soft tissue for open and endoscopic procedures in urologic surgery.

Product codes

LFL

Device Description

The Olympus Ultrasonic Surgical System is composed of three sections, (1), (2), and (3).

  • (1) Olympus SonoSurg Scissors 5mm O.D. T3050" or "Olympus SonoSurg Long Hook 5mm O.D. T3060" or "Olympus SonoSurg Long Scissors 5mm O.D. T3070", or "Olympus SonoSurg Scissors 5mm O.D., HF Series.
  • (2) Olympus SonoSurg Transducer SonoSurg-T2H.
  • (3) Olympus SonoSurg Generator Set SonoSurg-G2 Set (SonoSurg-G2, MAJ-51).

This device is intended to cut and coagulate soft tissue for open and endoscopic procedures in urologic surgery.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

soft tissue

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies

Not Found

Key Metrics

Not Found

Predicate Device(s)

K002981, K972114, K990430, K972114, K000095

Reference Device(s)

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information

Not Found

N/A

0

K031523 1 of 2

OCT - 1 2003

510(k) SUMMARY Olympus Ultrasonic Surgical System

This summary of 510(k) safety and effectiveness information is being submitted in accordance with the requirements of SMDA 1990 and 21 CFR, Section 807.92.

A. General Information

1. ApplicantAomori Olympus Co,. Ltd.
2-248-1, Okkonoki
Kuroishi-shi, Aomori-ken,
036-0357 Japan
(Registration No.: 9614641)
2. Submission CorrespondentMayumi Ishii
Olympus Optical Co., Ltd.
2951 Ishikawa-cho, Hachioji-shi,
Tokyo 192-8507, Japan
TEL: 81-426-42-2891
FAX: 81-426-42-2291
(Registration No.: 8010047)
3. Official CorrespondentTina Steffanie-Oak
Senior R.A. Analyst
Olympus America Inc.
Two Corporate Center Drive, Melville,
NY 11747-3157
TEL: 631-844-5477
FAX: 631-844-5416
E-mail: Tina. Steffanie-Oak@olympus.com
(Registration No.: 2429304)

B. Device Name, Common Name

1. Device Name :Olympus Ultrasonic Surgical System
2. Common/Usual Name :Ultrasonic Surgical System
3. Classification Name :Class II Instrument, Ultrasonic Surgical LFD

C. Predicate Devices :

#K002981 Harmonic Scalpel #K972114 Olympus SonoSurg Scissors Set T3000 #K990430 Hand piece #K972114 Olympus Transducer MAJ-336 #K000095 SonoSurg Generator Set SonoSurg-G2 Set

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K031523 20

D. Summary Description of the Device

1. Summarv

The Olympus Ultrasonic Surgical System is composed of three sections, (1), (2), and (3).

  • (1) Olympus SonoSurg Scissors 5mm O.D. T3050" or "Olympus SonoSurg Long Hook 5mm O.D. T3060" or "Olympus SonoSurg Long Scissors 5mm O.D. T3070", or "Olympus SonoSurg Scissors 5mm O.D., HF Series.
  • (2) Olympus SonoSurg Transducer SonoSurg-T2H.
  • (3) Olympus SonoSurg Generator Set SonoSurg-G2 Set (SonoSurg-G2, MAJ-51).

This device is intended to cut and coagulate soft tissue for open and endoscopic procedures in urologic surgery.

2. Design

"Olympus Ultrasonic Surgical System" has been designed, manufactured and tested in compliance with Voluntary Safety Standards. It meets the requirements of IEC 60601-1, IEC60601-1-1,IEC60601-1-2.

3. Materials

There are no new patient-contacting materials.

E. Intended Use of the device

Olympus Ultrasonic Surgical System has been designed to be used with the Olympus SonoSurg Generator Set (SonoSurg-G2 Set) and an electrosurgical unit to cut and coagulate soft tissue for laparoscopic and intraabdominal procedures in general(open) surgery. It is also designed to cut and coagulate soft tissue for open and endoscopic procedures in urologic surgery.

F. Technological Characteristics

Theory of the operation of "Olympus Ultrasonic Surgical System" is that the electrical energy employed in the "Olympus SonoSurg-G2" is changed to mechanical energy by ultrasonic vibration in the "Olympus SonoSurg Transducer SonoSurg-T2H". Therefore, this system can cut and coagulate body tissue by ultrasonic vibration. This system is the same as the Predicate Devices which include, "Olympus SonoSurg Scissors Set T3000(#K972114)", "Olympus Transducer MAJ-336 (#K972114)" and "Olympus SonSurg-G2 (#K000095)".

G. Reason for not requiring clinical data

When compared to the predicate devices, "Olympus Ultrasonic Surgical System" does not incorporate any significant changes that would effect safety or efficacy. Therefore clinical data is not necessary for its evaluation of safety.

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Image /page/2/Picture/1 description: The image shows the logo for the U.S. Department of Health & Human Services. The logo consists of a circular seal with the text "DEPARTMENT OF HEALTH & HUMAN SERVICES USA" arranged around the perimeter. Inside the circle is an abstract symbol resembling a stylized human figure or a bird in flight, composed of flowing lines.

Public Health Service

Food and Drug Administration 9200 Corporate Boulevard Rockville MD 20850

OCT - 1 2003

Aomori Olympus Co., Ltd. c/o Ms. Tina Steffanie-Oak Olympus America, Inc. Two Corporate Center Drive Melville, New York 11747-3157

Re: K031523

Trade/Device Name: Olympus Ultrasonic Surgical System Regulatory Class: Unclassified Product Code: LFL Dated: September 3, 2003 Received: September 4, 2003

Dear Ms. Steffanie-Oak:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to such additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

3

Page 2 - . Ms. Tina Steffanie-Oak

This letter will allow you to begin marketing your device as described in your Section 510(k) premarket notification. The FDA finding of substantial equivalence of your device to a legally marketed predicate device results in a classification for your device and thus, permits your device to proceed to the market.

If you desire specific advice for your device on our labeling regulation (21 CFR Part 801), please contact the Office of Compliance at (301) 594-4659. Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21CFR Part 807.97). You may obtain other general information on your responsibilities under the Act from the Division of Small Manufacturers, International and Consumer Assistance at its toll-free number (800) 638-2041 or (301) 443-6597 or at its Internet address http://www.fda.gov/cdrh/dsma/dsmamain.html

Sincerely yours,

Miriam C. Provost

Celia M. Witten, Ph.D., M.D. Director Division of General, Restorative and Neurological Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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Indications for Use Statement

510(k) Number(if known): _Not assigned yet. K03523 Device Name: Qlympus Ultrasonic Surgical System

Indications for Use :

OLYMPUS Ultrasonic Surgical System has been designed to be used with the Olympus SonoSurg generator Set (SonoSurg-G2 Set) and an electrosurgical unit to cut and coagulate soft tissue for laparoscopic and intraabdominal procedures in general (open) surgery. It is also designed to cut and coagulate soft tissue for open and endoscopic procedures in urologic surgery.

Miriam C. Provost

Division of General, Restorative and Neurological Devices

510(k) Number_KO3/5 @3

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Concurrence of CDRH, Office of Device Evaluation (ODE)


Prescription Use (Prescription 21 CFR 801.109) OR

Over-The-Counter Use

(Optional Format 1-2-96)